Wetenschappelijk onderzoek

Het protocol voor de behandeling van colitis ulcerosa is op basis van wetenschappelijke publicaties ontwikkeld. Hierbij is gebruik gemaakt van hoog gekwalificerd recent onderzoek dat wordt gepubliceerd in de PubMed database. placebo controlled onderzoek, meta analyses en reviews hebben de voorkeur. Dit soort onderzoek valt onder Evidence Based Medicine.

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Causes

Supplements

Probiotica

  1. Rembacken BJ, Snelling AM, Hawkey PM, Chalmers DM, Axon AT. Lancet. 1999 Aug 21;354(9179):635-9. Non-pathogenic Escherichia coli versus mesalazine for the treatment of ulcerative colitis: a randomised trial
    Our results suggest that treatment with a non-pathogenic E. coli has an equivalent effect to mesalazine in maintaining remission of ulcerative colitis. The beneficial effect of live E. coli may provide clues to the cause of ulcerative colitis.[Abstract]
  2. Cui HH, Chen CL, Wang JD, Yang YJ, Cun Y, Wu JB, Liu YH, Dan HL, Jian YT, Chen XQ. World J Gastroenterol. 2004 May 15;10(10):1521-5. Effects of probiotic on intestinal mucosa of patients with ulcerative colitis
    The probiotic could impede the activation of NF-kappaB, decrease the expressions of TNF-alpha and IL-1beta and elevate the expression of IL-10. These results suggest that oral administration of this new probiotic preparation is effective in preventing flare-ups of chronic UC. It may become a prophylactic drug to decrease the relapse of UC.[Article]
  3. Cui HH, Chen CL, Wang JD, Yang YJ, Sun Y, Wang YD, Lai ZS. Zhonghua Nei Ke Za Zhi. 2003 Aug;42(8):554-7. The effects of bifidobacterium on the intestinal mucosa of the patients with ulcerative colitis
    The Bf maybe impede the activation of NF-kappaB, decrease the expression of TNF-alpha and IL-1beta and elevate the expression of IL-10. These results suggest that oral administration of this new probiotic preparation is effective in preventing flare-ups of chronic UC. It will become a prophylactic drug delaying the relapse of UC.[Abstract]
  4. Cummings JH, Macfarlane GT, Macfarlane S. Curr Issues Intest Microbiol. 2003 Mar;4(1):9-20. Intestinal bacteria and ulcerative colitis
    Convincing evidence from both animal models and the study of patients with ulcerative colitis (UC) implicates the intestinal microflora in the initiation and maintenance of the inflammatory processes in this condition. (lactobacilli and bifidobacteria).[Abstract]
  5. Bai AP, Ouyang Q, Xiao XR, Li SF. Int J Clin Pract. 2006 Mar;60(3):284-8. Probiotics modulate inflammatory cytokine secretion from inflamed mucosa in active ulcerative colitis
    When cocultured with inflamed tissues of active ulcerative colitis, probiotics could inhibit NF-kappaB activation in LPMC and down-regulate inflammatory cytokine secretion from inflamed tissues of active ulcerative colitis.[Abstract]
  6. Sood A, Midha V, Makharia GK, Ahuja V, Singal D, Goswami P, Tandon RK. Clin Gastroenterol Hepatol. 2009 Nov;7(11):1202-9, 1209.e1 The probiotic preparation, VSL#3 induces remission in patients with mild-to-moderately active ulcerative colitis
    VSL#3 is safe and effective in achieving clinical responses and remissions in patients with mild-to-moderately active UC.[Abstract]
  7. Miele E, Pascarella F, Giannetti E, Quaglietta L, Baldassano RN, Staiano A. Am J Gastroenterol. 2009 Feb;104(2):437-43. Effect of a probiotic preparation (VSL#3) on induction and maintenance of remission in children with ulcerative colitis

    This is the first pediatric, randomized, placebo-controlled trial that suggests the efficacy and safety of a highly concentrated mixture of probiotic bacterial strains (VSL#3) in active UC and demonstrates its role in maintenance of remission.[Article]
  8. Bibiloni R, Fedorak RN, Tannock GW, Madsen KL, Gionchetti P, Campieri M, De Simone C, Sartor RB. Am J Gastroenterol. 2005 Jul;100(7):1539-46. VSL#3 probiotic-mixture induces remission in patients with active ulcerative colitis
    Treatment of patients with mild to moderate UC, not responding to conventional therapy, with VSL#3 resulted in a combined induction of remission/response rate of 77% with no adverse events. At least some of the bacterial species incorporated in the probiotic product reached the target site in amounts that could be detected.[Abstract]
  9. Tursi A, Brandimarte G, Giorgetti GM, Forti G, Modeo ME, Gigliobianco A. Med Sci Monit. 2004 Nov;10(11):PI126-31. Epub 2004 Oct 26. Low-dose balsalazide plus a high-potency probiotic preparation is more effective than balsalazide alone or mesalazine in the treatment of acute mild-to-moderate ulcerative colitis
    Balsalazide/VSL#3 may be a very good choice in the treatment of active mild-to-moderate active ulcerative colitis instead of balsalazide alone or mesalazine.[Abstract]

Synbiotica

  1. Furrie E, Macfarlane S, Kennedy A, Cummings JH, Walsh SV, O’neil DA, Macfarlane GT. Gut. 2005 Feb;54(2):242-9.
    Synbiotic therapy (Bifidobacterium longum/Synergy 1) initiates resolution of inflammation in patients with active ulcerative colitis: a randomised controlled pilot trial

    Short term synbiotic treatment of active UC resulted in improvement of the full clinical appearance of chronic inflammation in patients receiving this therapy.[Article]
  2. Fujimori S, Gudis K, Mitsui K, Seo T, Yonezawa M, Tanaka S, Tatsuguchi A, Sakamoto C. Nutrition. 2009 May;25(5):520-5. Epub 2009 Feb 8. A randomized controlled trial on the efficacy of synbiotic versus probiotic or prebiotic treatment to improve the quality of life in patients with ulcerative colitis
    Patients with UC on synbiotic therapy experienced greater quality-of-life changes than patients on probiotic or prebiotic treatment. These data suggest that synbiotic therapy may have a synergistic effect in the treatment of UC.[Abstract]
  3. Haskey N, Dahl WJ. Nutr Rev. 2006 Mar;64(3):132-8. Synbiotic therapy: a promising new adjunctive therapy for ulcerative colitis
    Prebiotic and probiotic therapies are new strategies being used to treat gastrointestinal diseases. Recent evidence suggests that the administration of select prebiotics and probiotics, alone or in combination (the latter called “synbiotic” therapy) may improve the clinical outcome of patients with ulcerative colitis. We report a case of a pediatric ulcerative colitis patient who showed increased length of remission, resolution of symptoms, and improved quality of life following the administration of synbiotic therapy. The literature supporting the use of prebiotic, probiotic, and synbiotic therapies in adult ulcerative colitis is also reviewed.[Abstract]
  4. Macfarlane GT, Blackett KL, Nakayama T, Steed H, Macfarlane S. Curr Pharm Des. 2009;15(13):1528-36. The gut microbiota in inflammatory bowel disease
    However, recent studies involving the use of probiotics, prebiotics and synbiotics suggest that there is potential for controlling these diseases through manipulation of the composition of the gut microbiota, and direct interactions with the gut immune system.[Abstract]

EPA / DHA


    CLINICAL
  1. Dichi I1, Frenhane P, Dichi JB, Correa CR, Angeleli AY, Bicudo MH, Rodrigues MA, Victória CR, Burini RC. Nutrition. 2000 Feb;16(2):87-90. Comparison of omega-3 fatty acids and sulfasalazine in ulcerative colitis

    In conclusion, treatment with sulfasalazine is superior to treatment with omega-3 fatty acids in patients with mild to moderate active ulcerative colitis.[Abstract]
  2. Bjørkkjaer T, Brunborg LA, Arslan G, Lind RA, Brun JG, Valen M, Klementsen B, Berstad A, Frøyland L. Scand J Gastroenterol. 2004 Nov;39(11):1088-94. educed joint pain after short-term duodenal administration of seal oil in patients with inflammatory bowel disease: comparison with soy oil
    The results suggest distinctive, differential prolonged effects on IBD-related joint pain of short-term duodenal administration of n-3-rich seal oil (significant improvement) and n-6-rich soy oil (tendency to exacerbation).[Abstract]

  3. RCT
  4. Barbosa DS, Cecchini R, El Kadri MZ, Rodríguez MA, Burini RC, Dichi I. Nutrition. 2003 Oct;19(10):837-42. Decreased oxidative stress in patients with ulcerative colitis supplemented with fish oil omega-3 fatty acids
    The results indicated that plasma oxidative stress occurs in patients with UC, and there was a significant decrease when the patients used sulfasalazine plus fish oil omega-3 fatty acids. However, there was no improvement in most laboratory indicators, sigmoidoscopy, and histology scores. The results suggested that omega-3 fatty acids may act as free radical scavengers protecting the patients against the overall effect of oxidative stress.[Abstract]

  5. REVIEW
  6. Ross E. Nutr Rev. 1993 Feb;51(2):47-9. The role of marine fish oils in the treatment of ulcerative colitis
    Recent studies suggest that marine fish-oil supplements, which are rich in n-3 fatty acids, may reduce the inflammation associated with ulcerative colitis. Fish oils may exert their beneficial effects by shifting eicosanoid synthesis to less inflammatory species or by modulating tissue levels of certain cytokines.[Abstract]
  7. Aslan A, Triadafilopoulos G. Am J Gastroenterol. 1992 Apr;87(4):432-7. Fish oil fatty acid supplementation in active ulcerative colitis: a double-blind, placebo-controlled, crossover study
    We conclude that fish oil dietary supplementation results in clinical improvement of active mild to moderate ulcerative colitis but is not associated with significant reduction in mucosal leukotriene B4 production, compared with placebo therapy.[Abstract]

  8. CLINICAL MULTICENTER
  9. Ann Intern Med. 1992 Apr 15;116(8):609-14. Dietary supplementation with fish oil in ulcerative colitis
    Four months of diet supplementation with fish oil in patients with inflammatory bowel disease resulted in reductions in rectal dialysate leukotriene B4 levels, improvements in histologic findings, and weight gain.[Abstract]
  10. Seidner DL, Lashner BA, Brzezinski A, Banks PL, Goldblum J, Fiocchi C, Katz J, Lichtenstein GR, Anton PA, Kam LY, Garleb KA, Demichele SJ. Clin Gastroenterol Hepatol. 2005 Apr;3(4):358-69. An oral supplement enriched with fish oil, soluble fiber, and antioxidants for corticosteroid sparing in ulcerative colitis: a randomized, controlled trial
    The improvement in clinical response combined with a decreased requirement for corticosteroids suggest that this enriched oral supplement can be a useful adjuvant therapy in patients with UC.[Abstract]
  11. REVIEW

  12. Cabré E1, Mañosa M, Gassull MA. Br J Nutr. 2012 Jun;107 Suppl 2:S240-52. doi: 10.1017/S0007114512001626. Omega-3 fatty acids and inflammatory bowel diseases – a systematic review

    The present systematic review does not allow to make firm recommendations about the usefulness of omega-3 PUFA in inflammatory bowel disease.[Abstract]

  13. .[Abstract]

  14. .[Abstract]

Boswellia serrata

  1. Gupta I, Parihar A, Malhotra P, Singh GB, Lüdtke R, Safayhi H, Ammon HP. Eur J Med Res. 1997 Jan;2(1):37-43. Effects of Boswellia serrata gum resin in patients with ulcerative colitis
    All parameters tested improved after treatment with Boswellia serrata gum resin, the results being similar compared to controls: 82% out of treated patients went into remission; in case of sulfasalazine remission rate was 75%.[Abstract]
  2. Ammon HP. Phytomedicine. 2010 Sep;17(11):862-7. Modulation of the immune system by Boswellia serrata extracts and boswellic acids
    From the pharmacological properties of BEs and BAs it is not surprising that positive effects of BEs in some chronic inflammatory diseases including rheumatoid arthritis, bronchial asthma, osteoarthritis, ulcerative colitis and Crohn’s disease have been reported.[Abstract]
  3. Ammon HP. Wien Med Wochenschr. 2002;152(15-16):373-8. Boswellic acids (components of frankincense) as the active principle in treatment of chronic inflammatory diseases
    In clinical trials promising results were observed in patients with rheumatoid arthritis, chronic colitis, ulcerative colitis, Crohn’s disease, bronchial asthma und peritumoral brains edemas.[Abstract]
  4. Ammon HP. Planta Med. 2006 Oct;72(12):1100-16. Boswellic acids in chronic inflammatory diseases
    Clinical studies, so far with pilot character, suggest efficacy in some autoimmune diseases including rheumatoid arthritis, Crohn’s disease, ulcerative colitis and bronchial asthma. Side effects are not severe when compared to modern drugs used for the treatment of these diseases.[Abstract]
  5. Gionchetti P, Rizzello F, Lammers KM, Morselli C, Sollazzi L, Davies S, Tambasco R, Calabrese C, Campieri M. World J Gastroenterol. 2006 Jun 7;12(21):3306-13. Antibiotics and probiotics in treatment of inflammatory bowel disease
    Both antibiotics and probiotics appear to play a beneficial role in the treatment and prevention of pouchitis and further trials are warranted to fully quantify their clinical efficacy.[Article]

Psyllium

  1. Fernández-Bañares F, Hinojosa J, Sánchez-Lombraña JL, Navarro E, Martínez-Salmerón JF, García-Pugés A, González-Huix F, Riera J, González-Lara V, Domínguez-Abascal F, Giné JJ, Moles J, Gomollón F, Gassull MA. Am J Gastroenterol. 1999 Feb;94(2):427-33. Randomized clinical trial of Plantago ovata seeds (dietary fiber) as compared with mesalamine in maintaining remission in ulcerative colitis. Spanish Group for the Study of Crohn’s Disease and Ulcerative Colitis (GETECCU)
    Plantago ovata seeds (dietary fiber) might be as effective as mesalamine to maintain remission in ulcerative colitis.[Abstract]
  2. Seidner DL, Lashner BA, Brzezinski A, Banks PL, Goldblum J, Fiocchi C, Katz J, Lichtenstein GR, Anton PA, Kam LY, Garleb KA, Demichele SJ.
    Source
    Departm Clin Gastroenterol Hepatol. 2005 Apr;3(4):358-69. An oral supplement enriched with fish oil, soluble fiber, and antioxidants for corticosteroid sparing in ulcerative colitis: a randomized, controlled trial

    The improvement in clinical response combined with a decreased requirement for corticosteroids suggest that this enriched oral supplement can be a useful adjuvant therapy in patients with UC.[Abstract]
  3. Kanauchi O, Suga T, Tochihara M, Hibi T, Naganuma M, Homma T, Asakura H, Nakano H, Takahama K, Fujiyama Y, Andoh A, Shimoyama T, Hida N, Haruma K, Koga H, Mitsuyama K, Sata M, Fukuda M, Kojima A, Bamba J Gastroenterol. 2002 Nov;37 Suppl 14:67-72. Treatment of ulcerative colitis by feeding with germinated barley foodstuff: first report of a multicenter open control trial
    Oral GBF therapy may have the potency to reduce clinical activity of UC. We believe that these results support the use of GBF administration as a new adjunct therapy for UC.[Abstract]
  4. RCT

  5. Fernández-Bañares F, Hinojosa J, Sánchez-Lombraña JL, Navarro E, Martínez-Salmerón JF, García-Pugés A, González-Huix F, Riera J, González-Lara V, Domínguez-Abascal F, Giné JJ, Moles J, Gomollón F, Gassull MA. Am J Gastroenterol. 1999 Feb;94(2):427-33. Randomized clinical trial of Plantago ovata seeds (dietary fiber) as compared with mesalamine in maintaining remission in ulcerative colitis. Spanish Group for the Study of Crohn’s Disease and Ulcerative Colitis (GETECCU)
    Plantago ovata seeds (dietary fiber) might be as effective as mesalamine to maintain remission in ulcerative colitis.[Abstract]

Curcuma longa

  1. Hanai H, Iida T, Takeuchi K, Watanabe F, Maruyama Y, Andoh A, Tsujikawa T, Fujiyama Y, Mitsuyama K, Sata M, Yamada M, Iwaoka Y, Kanke K, Hiraishi H, Hirayama K, Arai H, Yoshii S, Uchijima M, Nagata T, Koide Y. Clin Gastroenterol Hepatol. 2006 Dec;4(12):1502-6. Curcumin maintenance therapy for ulcerative colitis: randomized, multicenter, double-blind, placebo-controlled trial
    Curcumin seems to be a promising and safe medication for maintaining remission in patients with quiescent UC. Further studies on curcumin should strengthen our findings.[Abstract]
  2. Hanai H, Sugimoto K. Curr Pharm Des. 2009;15(18):2087-94. Curcumin has bright prospects for the treatment of inflammatory bowel disease
    The inhibitory effects of curcumin on major inflammatory mechanisms like COX-2, LOX, TNF-alpha, IFN-gamma, NF-kappaB and its unrivalled safety profile suggest that it has bright prospects in the treatment of IBD.[Abstract]
  3. Ng SC, Kamm MA. Inflamm Bowel Dis. 2009 Jun;15(6):935-50. Therapeutic strategies for the management of ulcerative colitis
    Preliminary supportive evidence is emerging in relation to novel antiinflammatory molecules such as curcumin, manipulation of the bacterial flora, enhancement of the mucosal barrier, and direct epithelial restoration.[Article]